Relationships between executive function, mentalization and earthquake-related stress reactions in adults

BACKGROUND: Academic research shows that mentalizing (MZ) and executive function (EF) are important components in maintaining mental health and in responding adaptively to stressors. Therefore, they may be better associated with post-traumatic stress-related mental health problems. However, studies of the relationship between EF, MZ and post-traumatic stress (PTS) symptoms have mostly focused on childhood traumas and related mental health problems. Few studies have examined the relationship of these variables with trauma types common in adulthood, such as exposure to an earthquake. OBJECTIVE: This study investigated the relationship between EF, MZ, and PTS symptoms, and tested whether specific dimensions of MZ moderate the EF-PTS link in a sample of adults exposed to the February 2023 earthquakes in Turkey. METHOD: I collected data from the three provinces in Turkey that experienced the most destruction and loss of life due to earthquakes that occurred on February 6 and 20, 2023. The participants completed the Adulthood Executive Functioning Inventory (ADEXI/ EF), the Certainty About Mental States Questionnaire (CAMSQ/MZ), and the Post-Traumatic Stress Disorder Checklist (PCL). Accordingly, I tested the moderating effect of CAMSQ self-certainty (SC), other-certainty (OC), and hypermentalizing (HMZ, i.e., other-self discrepancy) scores on the relationship between EF and PCL scores. RESULTS: The results indicate that SC (B = - 0.007, 95% CI - 0.024, 0.011, p = .462) and OC (B = - 0.009, 95% CI - 0.028, 0.009, p = .309) had no moderating effect on the relationship between EF and PCL, whereas HMZ showed a significant moderating effect (B = - 0.395, 95% CI - 0.740, - 0.049, p = .025). These findings suggest that both EF impairment (B = 1.770, 95% CI 1.078, 2.462, p < .001) and HMZ (B = 15.922, 95% CI 4.426, 27.419, p = .007) are strongly associated with PTS reactions among adults who have experienced earthquake trauma and challenging post-earthquake conditions. CONCLUSION: This study highlights the relationship between two important neurocognitive components and post-traumatic stress symptoms in adults. The results suggest that higher EF and optimal mentalizing may be related to better coping with prolonged post-disaster challenges. Interventions such as targeted cognitive training and mentalization-based strategies could be explored in future research to examine their potential for reducing vulnerability to chronic stress reactions.